NURS 4700 NURSING CONCEPTS AND INTERVENTIONS FOR THE CARE OF OLDER ADULTS II (Spinal Cord Injuries) CASE STUDIES MARQUETTE UNIVERSITY

NURS 4700 NURSING CONCEPTS AND INTERVENTIONS FOR THE CARE OF OLDER ADULTS II (Spinal Cord Injuries) CASE STUDIES MARQUETTE UNIVERSITY
Case Study #1
35-year-old women was on the way to the YMCA when she when she
turned left and was struck by another car. She was admitted to the ICU
yesterday. You are assessing her and find she is able to talk and breathe.
She can shrug her shoulders and is able to barely move her R hand off the
bed. Her left arm is not moving. Her legs are flaccid and she can’t feel
anything. She has no reflexes in her legs.
1. What do you think is the level of injury?
Most likely C6 level of injury based on the signs and symptoms the patient
presents.
What ongoing nursing assessments and care do you anticipate in caring for
this patient? Which nursing actions are priority?
Assessment
✓ ABC s – keep a patent airway
✓ Neurologic assessment
✓ Vital signs regularly
Actions
i. Iv fluids
ii. Immobilize patient to prevent further injury
iii. Anticoagulants to prevent DVT – lovenox (low molecular heparin)
iv. Proper nutrition to facilitate healing
v. Line tube placement
vi. Assess for injuries or control hemorrhaging
vii. Emotional support
Case 2:
Mr. P. is a 19-year-old African American man with a spinal cord injury
(paraplegic) from a gunshot wound with injury at the level of T10–T11. His
accident was 10 days ago, and he is now being admitted to the rehabilitation
unit.
Physical Examination
• Vital signs: supine blood pressure 120/68, sitting blood pressure
114/62, pulse 68, temperature 99.6° F, respirations 16
• Slight edema bilateral lower extremities